Obvious Calcification Research Articles

Calcification resistance for photooxidatively crosslinked acellular bovine jugular vein conduits in right-side heart implantation

This study aimed to investigate the effect of decellularization plus photooxidative crosslinking and ethanol pretreatment on bioprosthetic tissue calcification. Photooxidatively crosslinked acellular (PCA) bovine jugular vein conduits (BJVCs) and their photooxidized controls (n = 5 each) were sterilized in a graded concentration of ethanol solutions for 4 h, and used to reconstruct dog right ventricular outflow tracts. At 1-year implantation, echocardiography showed similar hemodynamic performance, but obvious calcification for the photooxidized BJVC walls. Further histological examination showed intense calcium deposition colocalized with slightly degraded elastic fibers in the photooxidized BJVC walls, with sparsely distributed punctate calcification in the valves and other areas of walls. But PCA BJVCs had apparent degradation of elastic fibers in the walls, with only sparsely distributed punctate calcification in the walls and valves. Content assay demonstrated comparable calcium content for the two groups at preimplantation, whereas less calcium for the PCA group in the walls and similar calcium in the valvular leaflets compared with the photooxidized group at 1-year retrieval. Elastin content assay presented the conduit walls of PCA group had less elastin content at preimplantation, but similar content at 1-year retrieval compared with the photooxidized group. Phospholipid analysis showed phospholipid extraction by ethanol for the PCA group was more efficacious than the photooxidized group. These results indicate that PCA BJVCs resist calcification in right-side heart implantation owing to decellularization, further photooxidative crosslinking, and subsequent phospholipid extraction by ethanol at preimplantation.

In Vivo Calcification of Glutaraldehyde-Fixed Cardiac Valve and Pericardium of Phoca groenlandica

Calcification remains the main reason for failure of bioprosthetic valves. The aim of this study was to evaluate the in vivo calcification response of a new bioprosthetic valve, derived from cardiac tissue of Phoca groenlandica. Aortic and pulmonary leaflets, bovine, and Phoca groenlandica pericardia were fixed in buffered glutaraldehyde solution. Tissues were divided into four groups: group 1, bovine pericardium (BP); group 2, pulmonary leaflets; group 3, seal pericardium; and group 4, aortic leaflets. All samples were implanted subdermally into four sets of eight female 12-day-old Wistar rats for 21 days. The tissues were divided into two parts for calcium measurement, and histology with hematoxylin-eosin, von Kossa, and Weigert Van Gieson staining. All groups experienced significant calcification. Group 1 with 1.39 mg/g (0.34) before and 125.78 mg/g (21.48) after implantation (p < 0.001), group 2 with 1.50 mg/g (0.43) before and 151.85 mg/g (19.1) after (p < 0.001), group 3 with 3.15 mg/g (0.62) before and 116.38 mg/g (33.74) after (p < 0.001), and group 4 with 1.84 mg/g (0.52) before and 126.95 mg/g (13.37) after (p < 0.001). Explant samples showed foreign body response, disorganized collagen, and obvious calcification. The cardiac valve and pericardium of Phoca groenlandica calcify to the same extent as the BP.

A young woman with multiple cardiac mass lesions

A 22-year-old woman presented with breathlessness, weight loss and anorexia of 6 months’ duration. Clinical examination was suggestive of mild to moderate cardiomegaly with systolic murmur. Routine laboratory investigations revealed normal cardiac enzymes. An electrocardiogram revealed T-wave inversion in lead II, III, aVF and I, aVL and V4–6. A chest radiograph showed widened mediastinal shadow with minimally multilobulated rightand left-sided margins of cardiac and mediastinal silhouette. No obvious calcifications or altered density difference was seen in this region. Twodimensional echo cardiography (not shown) revealed

Evaluation of the different resolution of grayscale display over the detection efficiency of pulmonary nodule

Objective To evaluate the influence of the resolution of medical grayscale LCD over the detective efficiency of pulmonary nodule.Methods By reviewing PACS, 93 on-line chest DR images were collected.These radiographs included 23 normal images that had no nodule confirmed by CT, 32 doubtful images that also had no nodule confirmed by CT,and 38 positive images that had nodules confirmed by CT.These nodules didn't show obvious calcification and their diameters were from 0.30 to 1.90 cm. Nine patients had multi-nodules.Three residents or postgraduates, three attending physicians, and three associate professors or professors interpreted the 93 chest images by using three types of displays: Barco Z-2261, Barco Z-3620 and Barco Z-5620.All observers evaluated their confidence of the presence of pulmonary nodule with five-point level rating scale : ( 1 ) definitely positive, ( 2 ) probably positive, ( 3 ) uncertain, (4) probably negative, (5)definitely negative.SPSS 11.5 software was used to analyze the results ,including to draw the ROC curves and to perform Z test.Results The areas under the ROC curves of 2 M display, 3 M display and 5 M display were 0.774,0.784,0.816 for experienced radiologists; for instructors were 0.754,0.764,0.768 ;for teaching assistants were 0.695,0.754,0.774.However, for the detection of pulmonary nodules,there was no significant difference between observers with different ranks using the same modality of display,and no significant difference was found between the different modalities of displays used by observers with the same rank.Conclusion It's equivalent for detection performance with 2,3 and 5 M medical grayscale LCD display in detecting pulmonary nodule; Experienced radiologists can get more information using 5 M display;By reasonably matching displays, we could improve the cost-efficacy. Key words: Sarcoidosis,pulmonary; ROC curve; Comparative study

Endoscopic methods for the diagnosis of chronic pancreatitis

Diagnosing chronic pancreatitis (CP) is challenging, particularly in patients with chronic abdominal pain but no obvious pancreatic insufficiency or calcifications. A variety of methods are available to diagnose and stage CP, but no gold standard currently exists, and diagnostic criteria are reliable only in severe CP. This review will focus on endoscopic methods for diagnosing early CP including endoscopic retrograde pancreatography (ERP), endoscopic ultrasound (EUS), and endoscopic pancreatic function testing (ePFT). These methods are often used in combination to diagnose or exclude CP. Although there are a variety of methods available, diagnosing mild and moderate CP remains a challenge, and further refinements of diagnostic criteria are needed to advance the field of endoscopic diagnosis of CP.

Sutureless anastomoses of rabbit carotid arteries with BioGlue

Sutureless anastomoses for coronary artery surgery are being investigated for a minimally invasive setup because they are easy to perform and less time-consuming than are sutured anastomoses. The short-term effects of the biocompatible adhesive BioGlue on vascular tissue have been described as potentially unfavorable. The present study investigates the medium-term macroscopic and histologic effects associated with the use of BioGlue on rabbit carotid arteries. Thirty-four carotid arteries of 17 New Zealand White rabbits were available. Nine carotid arteries were left unmanipulated and free of glue, 9 carotid arteries had BioGlue applied as a control, and 16 carotid arteries were transected and reanastomosed with the aid of BioGlue and an endovascular balloon. Of the 16 transected arteries, 4 had to be excluded from further evaluation. Angiographic scanning was performed 60 days postsurgery, after which the animals were euthanized and tissue samples were obtained for macroscopic and histologic examination. The application of BioGlue resulted in a marked invasion of inflammatory cells. The glue partially degraded and was replaced with connective tissue. Obvious calcification of the arterial wall and the capsule that had formed around the glue was present. Stenoses, thrombi, and pseudoaneurysms were predominantly noted in the glued anastomosis group. The results of this study raise concerns about the safety of BioGlue in coronary artery surgery. In light of our results, the use of BioGlue in large-vessel vascular surgery should be considered with great care for each individual patient.

CT and MRI diagnosis of intracranial chondroma

目的 总结探讨颅内软骨瘤的CT、MRI特点.方法对1994年1月至2004年9月经手术病理证实的10例颅内软骨瘤的CT、MRI特点进行回顾性分析.结果 10例中,肿瘤位于颅底4例,大脑凸面4例,大脑镰区、脑实质内各1例;CT上均见到明显的钙化且边缘清楚,密度多不均匀(9例),相邻骨质可受累(5例);于MRI上呈混杂信号(4例),其中钙化部分呈长T1、短T2信号,实质部分呈等长T1、长T2信号;CT增强扫描出现轻度强化4例,其中3例为延迟强化.结论颅内软骨瘤好发于颅底、大脑凸面及大脑镰区,多数伴有明显钙化,增强扫描呈轻度强化,延迟强化较有特点.病理仍是主要的确诊手段。

Diffuse Coronary Artery Disease and Dystrophic Calcification of the Radial Artery- Is There an Association?

Arterial revascularization is an attractive surgical option in the management of coronary artery disease (CAD). In the recent years, the radial artery (RA) has enjoyed resurgence in popularity as the preferred arterial conduit of choice after the internal mammary artery. Despite renewed interest in RA conduits, little is known of the prevalence of preexisting disease in this vessel, and in particular which patient subgroups are most affected, hence implications for long-term graft patency remain uncertain. We present our experience of three patients with diffuse CAD, found to have dystrophic calcification of their radial arteries intraoperatively. In all cases, the radial arteries were used, and the patients remain well and symptom-free. Soft tissue X-rays of the contra lateral forearm taken postoperatively demonstrated obvious calcification in the radial arteries in all patients. Diffuse CAD may reflect calcific disease in the RA. Suitability of a calcified RA as a conduit for CABG depends on long-term patency, which requires further evaluation.

Correlation of cell necrosis and tissue calcification with ischemia/reperfusion injury after liver transplantation

Background The cellular events following liver ischemia/reperfusion (I/R) during transplantation are largely unknown. The spectrum of I/R damage to the liver can be clinically revealed by the development of primary graft dysfunction or nonfunction. Because viral-induced liver necrosis has been associated with the development of calcifications in an animal model, we investigated the spectrum of I/R changes identified at an ultrastructural level among livers after liver transplant (LT). Materials and methods Random liver biopsies from five recipients with different degrees of liver dysfunction (LD) were processed for light (LM) and electron (EM) microscopic examination. The degree of calcification was estimated as mild–moderate or severe. The degree of cell vacuolization, used as a surrogate marker of cell necrosis, was reported as mild–moderate or severe. Results Two patients with severe LD had obvious calcifications by LM and EM examinations. Both showed significant vacuole formation, suggesting a severe degree of cell necrosis, and both succumbed to the sequelae of their LD. One patient showed evidence of mild calcifications at EM (but not LM) examination, with mild vacuole formation. The remaining two patients displayed no microcalcifications. Both presented only mild vacuole formation. Both patients recovered from LD and are currently alive. Conclusion In this preliminary report, we conclude that the clinically observed degree of LD after orthotopic liver transplant (OLT)correlates well with ultrastructural modifications. These include calcification and vacuole formation. We believe that both findings can be used as surrogate markers of a clinically significant hepatic I/R injury.

The Radiographic Features of Pulmonary Tuberculosis Observed for the Western Region of Saudi Arabia

The radiographs of 714 patients (486 males, 228 females) with proved pulmonary tuberculosis (PTB) were studied. Most were between 15 and 44 years of age, and most (86.8%) exhibited the usual radiographic appearance of PTB. All had extensive bilateral lung disease, with the right upper lobe the most commonly involved. Parenchymal opacities, cavitation, and atelectasis were common. Many radiographic patterns were encountered, and these varied from one radiograph to the next and even within the same radiograph, with two or more patterns seen together. Unusual radiographic manifestations were found in 13.2% of the patients. These included isolated opacities in the lower lobe, middle lobe, or lingula; normal chest radiographs; isolated pleural effusions; isolated mediastinal or hilar lymphadenopathy, and mass-like lesions. Permanent lung damage could be avoided if the various radiographic features of pulmonary tuberculosis were promptly recognized, thus leading to early treatment.

Ultrasound diagnosis and evaluation of fetal tumors.

Fetal tumors represent a rare and heterogeneous group of abnormalities. A significant proportion of them can now be diagnosed by using modern high resolution ultrasonic equipment. During 15 years there were 57 fetal tumours detected prenatally. Hygroma colli is the most frequent fetal tumor. It should be emphasized that cystic hygroma generally carries poor prognosis, and after an early diagnosis, termination of pregnancy is most logical approach. Contrary to the general opinion our own experience showed that there are cases in which prognosis could be much better as illustrated with our 4 cases. All of the treated fetuses, after surgical resection, had normal development and are now on the age of 5, 4, 3 and 2 years of life. An ovarian cyst can be suspected if a fluid-filled structure is visualized next to a fetal kidney and female external genitalia are recognizable. The ultrasound finding suggestive of an ovarian cyst is that of a pelvic cystic or complex mass in a female fetus with normal kidneys and urinary bladder and a normal gastrointestinal tract. In most cases, the normal course of fetal ovarian cyst is a spontaneous intrauterine or postnatal involution. Prenatal diagnosis improves neonatal outcome by allowing an appropriate choice of the optimal time, mode and place of delivery in order to avoid accidental and unexpected intrapartum and postnatal complications. The management of a fetus affected by an ovarian cyst depends on the size and on the echo-pattern of the cyst. It remains unclear whether in utero puncture of the cyst and evacuation of its content should be justified in cases of particularly large ovarian cyst. In our opinion intrauterine procedure can be attempted in the presence of large cyst fulfilling the fetal abdomen. We have treated actively two cases of large ovarian cysts by ultrasonically guided puncture before delivery and both fetuses underwent surgery later without complications. If properly performed puncture of the cyst seems to be a low risk procedure in comparison to potential problems that cyst may cause to the fetus or by causing dystocia. Sacrococcygeal teratoma represents the most frequent tumor in the fetuses and newborns. Prenatal diagnosis is usually simple and based on the visualization of tumor of variable size and internal structure. Tumors may appear as completely cystic, mixed or predominantly solid with obvious calcifications. Cystic and calcified tumors are most likely to be benign. Obstetrical management of sacrococcygeal teratoma depends on numerous parameters which include size and texture of the tumor, and gestational age.(ABSTRACT TRUNCATED AT 400 WORDS)

Hyperdensity of recent hemorrhage at body computed tomography: incidence and morphologic variation.

Body computed tomographic (CT) scans were reviewed in 73 patients with hematomas of recent onset. The incidence, extent, and morphologic variation of regions of hyperdensity on precontrast scans were assessed. Hyperdensity was also sought in the scans of 80 control subjects with a mass due to neoplasm or abscess demonstrated at CT. Of the 73 hematomas 55 (75%) exhibited regions of localized or diffuse hyperdensity. Only one of the 80 (1.25%) control lesions showed relative hyperdensity that could not be explained by obvious calcification, bone fragments, or diminished density of the organ of origin. Predominant hyperdensity throughout the lesion was present in 35 (48%) of the hematomas and in 16 (22%) of these was homogenous in texture. Other patterns of hyperdensity included linear shadows, hyperdense filling defects surrounded by fluid, dependent position of hyperdense fragments, and fluid fluid levels with dependent hyperdensity. Hyperdensity at CT was due to the high hemoglobin content of retracted clot or sedimented blood. The various patterns seen can be related to sequential changes occurring in blood following hemorrhage. Relative hyperdensity and its variations seen on precontrast scans are useful diagnostic signs of recent hemorrhage.